| Phoenix Health Center- La Clinica | |
|
3617 S Pacific Hwy Medford OR 97501 | |
| (541) 535-6239 | |
| (541) 512-1026 |
| Full Name | Phoenix Health Center- La Clinica |
|---|---|
| Speciality | Clinic/Center |
| Location | 3617 S Pacific Hwy, Medford, Oregon |
| Authorized Official Name and Position | Tara Lynette Jeannot (CHIEF OPERATIONS OFFICER) |
| Authorized Official Contact | 5415356239 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Phoenix Health Center- La Clinica 931 Chevy Way Medford OR 97504-4127 Ph: (541) 535-6239 | Phoenix Health Center- La Clinica 3617 S Pacific Hwy Medford OR 97501 Ph: (541) 535-6239 |
| NPI Number | 1851327571 |
|---|---|
| Provider Enumeration Date | 06/24/2006 |
| Last Update Date | 07/15/2019 |
| Medicare PECOS PAC ID | 0244143089 |
|---|---|
| Medicare Enrollment ID | O20031107000627 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851327571 | NPI | - | NPPES |
| 022868 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| Provider Name | Kenneth J Rhee |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1265497846 PECOS PAC ID: 7315830163 Enrollment ID: I20040205000229 |
| Provider Name | Leah F Schindler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306889969 PECOS PAC ID: 5193717569 Enrollment ID: I20040402001196 |
| Provider Name | Linda R Harris |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1891730826 PECOS PAC ID: 9638141245 Enrollment ID: I20040812000517 |
| Provider Name | Sheri R Clark |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821095241 PECOS PAC ID: 6608830872 Enrollment ID: I20041117000418 |
| Provider Name | Jessica H Diaz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578645404 PECOS PAC ID: 1456388073 Enrollment ID: I20050725001076 |
| Provider Name | Karen L Sauer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386687283 PECOS PAC ID: 5092737973 Enrollment ID: I20051220000298 |
| Provider Name | Sarah Ann Lamanuzzi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235243049 PECOS PAC ID: 9931114857 Enrollment ID: I20061204000523 |
| Provider Name | Kim A Mcquoid |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891792438 PECOS PAC ID: 6901902246 Enrollment ID: I20070503000439 |
| Provider Name | Lauralyn B Carter-meletich |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053577122 PECOS PAC ID: 8820163306 Enrollment ID: I20080818000664 |
| Provider Name | Richard H Foster |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265440473 PECOS PAC ID: 1557420775 Enrollment ID: I20081103000596 |
| Provider Name | Kelli Ann Lafleur |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386650398 PECOS PAC ID: 5991853830 Enrollment ID: I20090501000306 |
| Provider Name | Victoria A Cordy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497919161 PECOS PAC ID: 9638215361 Enrollment ID: I20091009000078 |
| Provider Name | Christopher D Alftine |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1073510483 PECOS PAC ID: 6204864085 Enrollment ID: I20101201000770 |
| Provider Name | Mary F Cutler |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649231523 PECOS PAC ID: 0749456374 Enrollment ID: I20120104000223 |
| Provider Name | Donna J Niemela |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194911032 PECOS PAC ID: 9537327572 Enrollment ID: I20120222000980 |
| Provider Name | Justin Adams |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760616866 PECOS PAC ID: 1052560356 Enrollment ID: I20121002000260 |
| Provider Name | Lauri Hoagland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265524482 PECOS PAC ID: 1254377260 Enrollment ID: I20121010000436 |
| Provider Name | Erin M Schorran |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033490784 PECOS PAC ID: 0244489060 Enrollment ID: I20121213000359 |
| Provider Name | Karen A Resnick |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1285771709 PECOS PAC ID: 6709892136 Enrollment ID: I20130123000598 |
| Provider Name | Brian C Marlia-larsen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780013110 PECOS PAC ID: 5698903631 Enrollment ID: I20140120000690 |
| Provider Name | Patricia Schein |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942242193 PECOS PAC ID: 2668602293 Enrollment ID: I20140227001443 |
| Provider Name | Elizabeth Banowetz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639406333 PECOS PAC ID: 6406097898 Enrollment ID: I20140613001856 |
| Provider Name | Lori D Braughton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578963443 PECOS PAC ID: 3779808332 Enrollment ID: I20150203000680 |
| Provider Name | Matthew John Hogge |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912203183 PECOS PAC ID: 4688988926 Enrollment ID: I20150730014137 |
| Provider Name | Rebecca Rose |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1174634794 PECOS PAC ID: 2264621119 Enrollment ID: I20160812000240 |
| Provider Name | Lori Jo Marlia-larsen |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1114260650 PECOS PAC ID: 5698062859 Enrollment ID: I20161003001430 |
| Provider Name | Rebecca Rampton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528506334 PECOS PAC ID: 7416232285 Enrollment ID: I20170316002156 |
| Provider Name | Beverly Anne Copeland |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285631655 PECOS PAC ID: 7517871023 Enrollment ID: I20180118001328 |
| Provider Name | Rita Goehring |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962883140 PECOS PAC ID: 4688950009 Enrollment ID: I20180406000480 |
| Provider Name | Rosa Ruggiero |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558524348 PECOS PAC ID: 5698947497 Enrollment ID: I20190409003070 |
| Provider Name | Carolina Mona-keene |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255845319 PECOS PAC ID: 9436419355 Enrollment ID: I20190604003067 |
| Provider Name | Stephanie A Estes |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1003357401 PECOS PAC ID: 8123396595 Enrollment ID: I20190925000413 |
| Provider Name | Kristopher Azevedo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558757997 PECOS PAC ID: 7214243567 Enrollment ID: I20191004003058 |
| Provider Name | Amanda Rae Maitland |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1891295176 PECOS PAC ID: 9032474317 Enrollment ID: I20191113001555 |
| Provider Name | Nathaniel A Fondell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346695236 PECOS PAC ID: 1850674243 Enrollment ID: I20191202000161 |
| Provider Name | Ireli Yudith Hernandez |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1255983904 PECOS PAC ID: 6709213093 Enrollment ID: I20200226001933 |
| Provider Name | Jessica Nawoichik |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366755019 PECOS PAC ID: 9537314778 Enrollment ID: I20200402002292 |
| Provider Name | Stacey Lynn Andrews |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497376826 PECOS PAC ID: 6002238854 Enrollment ID: I20200624000297 |
| Provider Name | Kelly Eileen Church |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598309387 PECOS PAC ID: 8820412869 Enrollment ID: I20200722004051 |
| Provider Name | Jamie S Osborn |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316972193 PECOS PAC ID: 5294867776 Enrollment ID: I20201014003929 |
| Provider Name | Jorge Palomino Vargas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760845846 PECOS PAC ID: 8224377619 Enrollment ID: I20210104002114 |
| Provider Name | Victor Paul Garcia |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619575875 PECOS PAC ID: 0648686469 Enrollment ID: I20210302003012 |
| Provider Name | Hannah Bampton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588949374 PECOS PAC ID: 1850630591 Enrollment ID: I20211215002470 |
| Provider Name | Kyle J Rutledge |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1265828446 PECOS PAC ID: 9133499460 Enrollment ID: I20220727001045 |
| Provider Name | Patricia Demaio |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295746295 PECOS PAC ID: 2860448172 Enrollment ID: I20220817001400 |
| Provider Name | Branddy Walter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619325438 PECOS PAC ID: 7719363910 Enrollment ID: I20220926000692 |
| Provider Name | Ariela Nacach Schnyer |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1649994575 PECOS PAC ID: 1850769050 Enrollment ID: I20221118002384 |
| Provider Name | Jessica K Langston |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033361373 PECOS PAC ID: 7315081973 Enrollment ID: I20230425000993 |
| Provider Name | Elena Wade |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952736548 PECOS PAC ID: 2860627577 Enrollment ID: I20230601002032 |
| Provider Name | Deborah Silbowitz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629751078 PECOS PAC ID: 4082077821 Enrollment ID: I20230828002307 |
| Provider Name | Elizabeth Fairweather |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437757374 PECOS PAC ID: 7719331040 Enrollment ID: I20230920003060 |
| Provider Name | Julie Graham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053199802 PECOS PAC ID: 4486009404 Enrollment ID: I20231011003165 |
| Provider Name | Megan Schneider |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124363866 PECOS PAC ID: 8426288911 Enrollment ID: I20240108005826 |
| Provider Name | David Scott |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1699976407 PECOS PAC ID: 7214389147 Enrollment ID: I20240116004690 |
Ups Medford (cdrc - Expansion) Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2825 E Barnett Rd, Medford, OR 97504 Phone: 503-494-9000 | |
Rogue Community Health Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 900 E Main St, Medford, OR 97504 Phone: 541-842-7705 Fax: 541-842-7640 | |
Columbiacare Services Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3200 Juanipero Way, Medford, OR 97504 Phone: 541-858-8170 Fax: 541-858-8167 | |
Pmg Medford Physiatry Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 920 Royal Ave, Medford, OR 97504 Phone: 541-732-8400 Fax: 541-732-8401 | |
Pmg South Heart Rhythm Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1698 E Mcandrews Rd, Ste 300, Medford, OR 97504 Phone: 541-732-7850 Fax: 541-732-7851 | |
Complete Integrative Care, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3156 State St, Medford, OR 97504 Phone: 541-773-5772 Fax: 541-773-1113 | |
La Clinica Acute Care Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 638 Market St, Medford, OR 97504 Phone: 541-494-3840 Fax: 541-494-1789 |